In efforts to mitigate risks and reduce incidences and medical legal claims, risk management programs in acute healthcare settings analyze historical data to determine root causes, improve care delivery processes and ultimately mitigate further harm. In order to maintain highly coordinated, strategic and systemic frameworks required to identify risks, risk management teams must fundamentally expand beyond grounded, compartmentalized and decentralized issues management. As a strategy to identify an applicable solution, this Major Research Project (MRP) trials foresight methods to identify risks in acute care settings. Using a foresight technique called horizon scanning, seventeen risks were identified to form a draft futures risk registry. A delphi study was conducted whereby the identified risks were rated upon by a panel of healthcare experts. Consensus was reached on eleven risks over two rounds of polling, which formed the 2025 futures risk registry; a registry that can be applicable to any comparable acute care hospital. The study concludes with three operational strategies to imbed the trailed foresight methods into routine hospital risk identification processes.